Basic Information
| Provider Information | |||||||||
| NPI: | 1265405575 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAVE | ||||||||
| FirstName: | SNEHLATA | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 585 597 MERRIMACK STREET | ||||||||
| Address2: | LOWELL COMMUNITY HEALTH CENTER | ||||||||
| City: | LOWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789379700 | ||||||||
| FaxNumber: | 9784469830 | ||||||||
| Practice Location | |||||||||
| Address1: | 597 MERRIMACK STREET | ||||||||
| Address2: | LOWELL COMMUNITY HEALTH CENTER | ||||||||
| City: | LOWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789379700 | ||||||||
| FaxNumber: | 9784469830 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2006 | ||||||||
| LastUpdateDate: | 04/06/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 56557 | MA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 042881348 | 01 | ONE HEALTH | OTHER | 001262 | 01 | NEIGHBORHOOD HEALTH PLAN | OTHER | 042881348 | 01 | BEECH STREET | OTHER | 042881348 | 01 | UNICARE | OTHER | 204780 | 01 | HARVARD PILGRIM HEALTH CA | OTHER | 3073602 | 01 | AETNA | OTHER | 731686 | 01 | TUFTS | OTHER | J06598 | 01 | BLUE CROSS BLUE SHIELD | OTHER | J0659801 | 01 | MA | MEDICARE PTAN | OTHER | 1203911 | 01 | UNITED HEALTH CARE | OTHER | 1305557 | 05 | MA | MEDICAID | 33802 | 01 | FALLON | OTHER | 72268 | 01 | CIGNA | OTHER | 979893 | 01 | NETWORK HEALTH | OTHER | 042881348 | 01 | CHOICECARE | OTHER |